title: Three-dimensional contrast-enhanced magnetic resonance venography for detection of renal vein thrombosis: comparison with multidetector CT venography.
abstract: BACKGROUND
  Renal vein thrombosis is not uncommon, however, there have been few reports on the diagnostic accuracy of three-dimensional contrast-enhanced magnetic resonance venography (3D-CE-MRV) in the detection of renal vein thrombosis (RVT).
  
  
  OBJECTIVE
  To evaluate the value of 3D-CE-MRV for detecting RVT with multidetector computed tomography (CT) venography as reference standard.
  
  
  METHODS
  Thirty-two patients with nephrotic syndrome underwent renal CT venography and gradient echo pulse sequence (FLASH 3D) 3D-CE-MRV in a clinical 3-T whole-body MR scanner for suspected RVT with time interval of 0-5 days. RVT was recorded on a per-patient and per-vessel (left renal vein, right renal vein, and inferior vena cava) basis. The diagnostic accuracy of 3D-CE-MRV for detection of RVT was calculated with CT venography as reference standard. Inter-reader agreement for RVT detection was evaluated using Kappa statistics.
  
  
  RESULTS
  Of 32 patients, CT venography detected 22 vessels with thrombosis in 17 patients, including five in right renal veins, 14 in left renal veins, and three in inferior vena cava, while 15 patients had no RVT. 3D-CE-MRV detected 21 vessels (21/96, 21.9%) with thrombosis in 16 patients (6/32, 50%), including five in right renal veins, 13 in left renal veins, and three in inferior vena cava, while 16 patients (16/32, 50%) had no RVT. With CT venography as reference standard, the sensitivities and specificities of 3D-CE-MRV for RVT detection were 94.1%, 100%; 95.5%, 100% on a per-patient and a per-vessel basis, respectively. Excellent inter-reader agreement (Kappa value = 0.969, P < 0.001) was observed for RVT detection.
  
  
  CONCLUSIONS
  3D-CE-MRV has a high diagnostic accuracy in the detection of RVT, which is optimal alternative imaging modality in the detection of RVT.
authors.affiliation: Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, PR China.
authors.forename: Long Jiang
authors.initials: LJ
authors.lastname: Zhang
authors.forename: Xinsheng
authors.initials: X
authors.lastname: Wu
authors.forename: Gui Fen
authors.initials: GF
authors.lastname: Yang
authors.forename: Chun Xiang
authors.initials: CX
authors.lastname: Tang
authors.forename: Song
authors.initials: S
authors.lastname: Luo
authors.forename: Chang Sheng
authors.initials: CS
authors.lastname: Zhou
authors.forename: Xue Man
authors.initials: XM
authors.lastname: Ji
authors.forename: Guang Ming
authors.initials: GM
authors.lastname: Lu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003287:Contrast Media; D005260:Female; D006801:Humans; D007089:Image Enhancement; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D009404:Nephrotic Syndrome / Q000150:complications; D015588:Observer Variation; D010690:Phlebography; D012082:Renal Veins / Q000473:pathology*; D012680:Sensitivity and Specificity; D013927:Thrombosis / Q000175:diagnosis*
chemical_list: D003287:Contrast Media
keywords: Renal vein thrombosis; X-ray; angiography; computed tomography; magnetic resonance imaging